Community-based participatory action research: transforming multidisciplinary practice in primary health care

Hills, Marcia; Mullett, Jennifer; Carroll, Simon

doi:10.1590/s1020-49892007000200007

Cited by 39 publications

(37 citation statements)

References 17 publications

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“…The studies were from 11 countries and most of the studies were conducted in Canada ( n = 17) [45, 51–53, 55, 57, 63, 65, 66, 71, 78–80, 82–84, 87], followed by the USA ( n = 12) [40, 43, 44, 47, 49, 56, 58, 72, 76, 77, 85, 86], the UK ( n = 7) [39, 48, 59, 64, 68, 70, 81], Australia ( n = 4) [42, 73–75], New Zealand ( n = 2) [41, 62], Sweden ( n = 2) [54, 67], France ( n = 1) [50], Spain ( n = 1) [46], Netherlands ( n = 1) [60], Brazil ( n = 1) [61] and Republic of South Africa ( n = 1) [69]. Thirty-two different primary care professionals participated in these studies, with most of the data relating to General Practitioners/Family Physicians (42 papers), nurses (35 papers), pharmacists (14 papers) and administrative staff (11 papers) (Table 3).…”

Section: Resultsmentioning

confidence: 99%

Assessing the facilitators and barriers of interdisciplinary team working in primary care using normalisation process theory: An integrative review

et al. 2017

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BackgroundInterdisciplinary team working is of paramount importance in the reform of primary care in order to provide cost-effective and comprehensive care. However, international research shows that it is not routine practice in many healthcare jurisdictions. It is imperative to understand levers and barriers to the implementation process. This review examines interdisciplinary team working in practice, in primary care, from the perspective of service providers and analyses 1 barriers and facilitators to implementation of interdisciplinary teams in primary care and 2 the main research gaps.Methods and findingsAn integrative review following the PRISMA guidelines was conducted. Following a search of 10 international databases, 8,827 titles were screened for relevance and 49 met the criteria. Quality of evidence was appraised using predetermined criteria. Data were analysed following the principles of framework analysis using Normalisation Process Theory (NPT), which has four constructs: sense making, enrolment, enactment, and appraisal. The literature is dominated by a focus on interdisciplinary working between physicians and nurses. There is a dearth of evidence about all NPT constructs apart from enactment. Physicians play a key role in encouraging the enrolment of others in primary care team working and in enabling effective divisions of labour in the team. The experience of interdisciplinary working emerged as a lever for its implementation, particularly where communication and respect were strong between professionals.ConclusionA key lever for interdisciplinary team working in primary care is to get professionals working together and to learn from each other in practice. However, the evidence base is limited as it does not reflect the experiences of all primary care professionals and it is primarily about the enactment of team working. We need to know much more about the experiences of the full network of primary care professionals regarding all aspects of implementation work.Systematic review registrationInternational Prospective Register of Systematic Reviews PROSPERO 2015: CRD42015019362.

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Section: Resultsmentioning

confidence: 99%

Assessing the facilitators and barriers of interdisciplinary team working in primary care using normalisation process theory: An integrative review

et al. 2017

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“…This implies a need to adjust the design to target groups and local norms [23]. Involvement of both users and health care professionals in programme development is highly promoted [16,24], but still seems to be limited in practice. To the best of our knowledge, no studies demonstrate that adaptations and adjustments will be a sufficient approach to support programme development.…”

Section: Introductionmentioning

confidence: 99%

Characteristics of a self-management support programme applicable in primary health care: a qualitative study of users’ and health professionals’ perceptions

Solberg

Steinsbekk

Solbjør

et al. 2014

BMC Health Serv Res

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BackgroundDevelopment of more self-management support programmes in primary health care has been one option used to enhance positive outcomes in chronic disease management. At present, research results provide no consensus on what would be the best way to develop support programmes into new settings. The aim of the present study was therefore to explore users’ and health professionals’ perceptions of what would be the vital elements in a self - management support programme applicable in primary health care, how to account for them, and why.MethodsFour qualitative, semi-structured focus group interviews were conducted in Central Norway. The informants possessed experience in development, provision, or participation in a self-management support programme. Data was analysed by the Systematic Text Condensation method.ResultsThe results showed an overall positive expectation to the potential benefits of development of a self-management support programme in primary health care. Despite somewhat different arguments and perspectives, the users and the health professionals had a joint agreement on core characteristics; a self-management support programme in primary health care should therefore be generic, not disease specific, and delivered in a group- based format. A special focus should be on the everyday- life of the participants. The most challenging aspect was a present lack of competence and experience among health professionals to moderate self-management support programmes.ConclusionsThe development and design of a relevant and applicable self-management support programme in primary health care should balance the interests of the users with the possibilities and constraints within each municipality. It would be vital to benefit from the closeness of the patients’ every-day life situations. The user informants’ perception of a self-management support programme as a supplement to regular medical treatment represented an expanded understanding of the self-management support concept. An exploring approach should be applied in the development of the health professionals’ competence in practice. The effect of a self-management support programme based on the core characteristics found in this study needs to be evaluated.

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“…If, on one hand, the opportunity to acquire new knowledge, easy access to professionals and health services, feelings of appreciation, belonging, self-esteem, prestige and acknowledgement are positive characteristics, on the other hand, dissatisfaction with qualifications and inappropriate training, difficulty interacting and communicating with the team's other professionals, frustration, uncertainty, helplessness, and a feeling of worthlessness are posed as limitations (7,9,(12)(13) . Considering that a team is a structure in a process of constant disruption and re-structuring, not only a group of professionals working together (14) , this study sought to understand the social relations established between CHAs and the FHS team based on the work process of the health staff, highlighting the aspects of joint action and interaction among workers.…”

Section: Theoretical Supportmentioning

confidence: 99%

Articulação das ações e interação dos Agentes Comunitários de Saúde na equipe de Saúde da Família

Sakata¹,

Mishima

2012

Rev. esc. enferm. USP

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RESUmoO estudo de abordagem qualitativa teve como objetivo compreender as relações sociais entre o Agente Comunitário de Saúde (ACS) e a equipe de Saúde da Família (SF), nesse sentido, destaca-se a articulação das ações e a interação entre trabalhadores. Foram realizadas 23 observações participantes e 11 entrevistas semiestruturadas com uma equipe de SF em um município do interior de São Paulo, Brasil. Identificou-se que o ACS, como elo, desenvolve ações operacionais para agilizar o trabalho da equipe. Como laços de ligação, desempenham ações articuladas ao trabalho da equipe, interagindo com os trabalhadores, construindo planos assistenciais em comum, aproximando equipe e comunidade, adequando ações de cuidado às necessidades das pessoas. Na prática comunicativa, ao falarem de si, falam da pró-pria comunidade, pois é seu representante e porta-voz na equipe. Concluiu-se que o Agente Comunitário de Saúde pode ser um trabalhador estratégico se suas ações compreenderem uma dimensão mais política e social do trabalho em saúde.

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Community-based participatory action research: transforming multidisciplinary practice in primary health care

Cited by 39 publications

References 17 publications

Assessing the facilitators and barriers of interdisciplinary team working in primary care using normalisation process theory: An integrative review

Assessing the facilitators and barriers of interdisciplinary team working in primary care using normalisation process theory: An integrative review

Characteristics of a self-management support programme applicable in primary health care: a qualitative study of users’ and health professionals’ perceptions

Articulação das ações e interação dos Agentes Comunitários de Saúde na equipe de Saúde da Família

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